Advice + FAQs

What is lactose intolerance?

Lactose intolerance is a condition where your body has problems digesting lactose, a type of sugar found in milk. Lactose can’t be absorbed by the body as it is, so when you eat anything containing it, an enzyme called lactase in your digestive system breaks down the lactose into other simple sugars which can be absorbed into your body. Unfortunately, many people don’t have enough lactase in their systems.

What are the symptoms?

The symptoms of lactose intolerance include bloating, stomach cramps and pains, diarrhoea, flatulence and nausea. It is exceedingly common. The figures vary, but studies suggest that, for example, 15% of the British population is lactose intolerant. Worldwide, it’s estimated that some 65% of adults have some level of difficulty digesting lactose.

I think I’m lactose intolerant – what should I do?

If you think you might be lactose intolerant, it is always advisable to speak to your doctor first and keep a food and symptoms diary. They may suggest an elimination diet or, in some instances, further blood sugar or other tests which can diagnose lactose intolerance. They will also want to rule out other conditions.

What is a milk allergy?

Cow’s milk allergy is an immune-system response to one or more of the proteins in cow’s milk (most commonly casein). This type of allergy is called an IgE-mediated milk allergy. When people with the allergy consume milk, the body goes into red-alert, mistakenly producing antibodies to fight off what it perceives as a threat. The symptoms come on quickly and can include a rash or hives, eczema, wheezing and coughing, swollen lips, vomiting and stomach pain. In rare cases, it can cause anaphylaxis, which needs immediate emergency treatment.

There is also another type of cow’s milk allergy – called a non-IgE-mediated cows’ milk protein allergy. It was formerly called a milk protein intolerance, but the NHS in the UK classifies it as an allergy. It is more common in children, and symptoms include eczema, vomiting, stomach cramps and diarrhoea, but not hives or wheezing/breathing problems. The symptoms can take longer to develop than with an IgE-mediated allergy, and can often develop a few hours after consuming milk products.

Milk allergies are more common in children than adults. It affects around 2-5% of babies and young children and usually starts in infancy. Luckily, many children with milk allergy grow out of it and only 0.1% of people over the age of 5 have a milk allergy.

If you suspect that you or your child has a milk allergy, you should always consult your doctor.

I’ve just found out I can’t eat dairy – what can and can’t I eat?

Don’t panic!

Dairy products include all milk, cheeses, butter and yogurt from cows, buffalo, goats and sheep. Plus, of course, processed foods like chocolate and buttery pastry. If you are lactose intolerant you may be able to tolerate small amounts of these products, especially from non-cow’s milk sources (cow’s milk contains much higher levels of lactose). The severity of lactose intolerance varies from person to person, so try eating small amounts of these products to start with and keep a food diary, to work out how much you can tolerate without discomfort.

If you have a form of milk allergy, you will need to avoid these foods altogether.

You’ll also need to read labels carefully. Look out for the following terms, which are all ingredients that contain milk and can show up everywhere from crisps to wine (yes, really): Buttermilk, Casein, Caseinates, Ghee, Milk protein. Milk powder, Milk solids, Skimmed milk powder, Whey.

The good news is there are lots of alternatives including almond milk, soya milk, oat cream, coconut milk and cream, coconut yogurt, nut butters and eggs (yes, despite popular misconceptions, eggs are NOT dairy). You’ll find lots of simple recipes on this site and in my book using these ingredients.

How can I ensure I’m getting enough calcium in my diet?

Adults need 700mg of calcium a day, preferably from your diet, and a balanced dairy-free diet which includes non-dairy milks and certain calcium-rich foods should do this. If you’re concerned about the amount of calcium in your diet, talk to your doctor before taking supplements, as supplements in high doses can be harmful.

Look for dairy-free milks such as soya, almond and oat milk which have been fortified with calcium. If you are lactose intolerant, rather than allergic to milk, you could also try lactose-free milk, which uses a special process to remove all the lactose from milk. For babies with a milk allergy, consult your doctor who can advise on the most suitable type of formula.

The following foods are also rich sources of calcium. Include them in your diet wherever possible:

Dark leafy greens like kale, broccoli and watercress Most nuts including almonds, Brazil nuts and hazelnuts
Tofu
Pulses
Sesame seeds
Salmon
Sardines
Soya beans
Wholegrains, including wholegrain bread

It’s also important to get plenty of Vitamin D, as this helps your body absorb calcium. Eggs, fortified cereals and oily fish are all good sources.

For more information and advice visit www.nhs.uk and www.allergyuk.org